Health And Safety

IMMACULATE

She walked in to the surgery with her mother. She stood slightly behind the older woman, grasping her hand even though at fifteen, she should have been more confident; more self-assured. I welcomed them in and asked them to take a seat, and the mother sat dominantly in the chair usually selected by the principle patient, while Charlotte sat to the side, with her head bowed.

"How may I help?" I asked, and the mother cleared her throat, an expression of confusion on her usually stern face.

"It's Charlotte, Doctor. She's had some unusual reactions to that vaccine which you gave her a few weeks ago.

I rolled my eyes as I turned to the computer and opened her notes. So many parents were concerned about the ill-effects of vaccines, and yet the only issue I had encountered was the potential for kids who went unvaccinated to create risks for those who had.

Charlotte had been my patient for years - a gentle, academic and well-behaved girl whom I admit was one of my favourite charges. She was polite, and never presented with the usual angst-ridden issues of other girls her age. I felt sorry as I glanced at her, knowing that was very likely about to change for good.

"What type of effects? Charlotte?"

The young girl looked at me for the first time, and blushed. I leaned towards her, waiting for her to speak.

"I've been feeling very sick each morning. And I'm putting weight on, and I feel so tired." the child admitted. I nodded, and smiled at her.

"What makes you think it could be the vaccine which has caused these symptoms? Because, it sounds like they could be caused from any number of issues?" I looked closely at Charlie. She didn't appear to be the sort to be sleeping around without protection, but then again, I'd been surprised before.

Charlie shrugged a little, and looked to her mother. I smiled inwardly, wondering how much coaching the child had received prior to coming in to her appointment. Her mother looked at Charlotte fondly, and I felt a twinge of sympathy for what was most likely about to happen.

"All of the symptoms began immediately after the vaccine. So, it's logical to assume that it is the cause, isn't it?"

I made a reassuring non-committal noise and indicated for Charlotte to hop on to the examination table. I asked her quietly if she was happy for her mother to remain, and she emphatically nodded, which surprised me a little. Most young girls who had taken some sexual risk were only too desperate to get their mothers out of the way, so that they could discuss it frankly with me.
I asked her a few more questions and then gave her a small pot, and sent her off to do a sample. Her mother and I sat in silence, waiting, until she returned and handed it to me shyly.

Standing at my desk, I popped a strip in to the urine and waited for a few seconds. As expected, the strip quickly developed a blue line. I closed my eyes for a moment, planning how best to speak to the patient and her mother without upsetting them. I decided to be blunt.

"Well, Charlie, I think we can rule out any issue with the vaccination, sweetheart, as you look to be at least four weeks pregnant."

Charlotte's mother stood upright, her face a picture of shock, disbelief, and anger. She shook her head vehemently.
"It's not possible. It simply isn't possible. We are a strong, committed Christian family, and Charlotte would NEVER engage in sin prior to marriage. Never."

I glanced at Charlotte, whose pretty young face matched that of her mother, in terms of her shocked expression. I shrugged, and washed my hands.

"I'm afraid that these things happen, Mrs. Magdalen. Now we need to be very calm, and discuss the best way to move forward to protect Charlotte, and make sure that she chooses an outcome which is best for herself, and her future. I appreciate this is a shock, but we have to stay calm," I said. Charlotte continued to gaze at me, her expression a mask of shock.

"Charlotte, have you had unprotected sex?" I asked gently, and sighed as she shook her head vehemently.
"Well, may I do a physical examination, just to check you over?"
She looked at her mother, fearful, and her mother nodded quickly.
Charlotte stood and slipped out of her skirt behind the screen, and I asked her to lie on the examination table. I felt sorry for her, as she lay quaking in fear. I placed my hand on hers, and gave it a quick squeeze of reassurance before I popped some gloves on and examined her.

He mother started talking, perhaps to fill the silence and dispel some tension. "I just know it was the vaccine. Charlotte has not been in any situation which would compromise her virginity. She is a quiet, good, church-going Christian who believes in the sanctity f marriage. This must be a miracle. A miracle. She has been chosen, doctor, surely? An immaculate conception?"

I ignored her, concerned for the way her words may impact Charlotte. I'd known it before when young girls were so strongly influenced by parents that they had begin to deny reality themselves, to the point that they genuinely believed in their own deception. It was dangerous. Also ,the confusion of religion could mean that Charlotte's schooling was effectively over, and she was about to be consigned to an early motherhood, just because of her mother's own denial.

Charlotte tensed as I examined her. I paused for a moment, in confusion. I checked her out, and there was her hymen, perfectly in tact. I checked again, with the soothing sounds of her mother praying joyfully behind the screen. Charlotte was tense and shy when I touched her, as if she was unaccustomed to the invasion of her privacy in this way.

"So, Charlotte? Have you been with any boys at all? Maybe just messing around?" I knew the chances of a girl becoming pregnant without penetrative sex were slim, but it was obviously possible. My patient shook her head, staring at me in fear.
"No. I promise. I don't even talk to boys. I don't like them." she said, and her clear gaze unsettled me. I asked her to climb down and get dressed, and return to her seat in the surgery.

As I removed my gloves and washed my hands, the mother's prayers continued and I shook my head, frowning. In all my years working at the surgery I assumed I had encountered most odd situations, but this had to be the strangest. There was something about Charlotte's innocence, and the clarity in her eyes, that almost made me inclined to believe her. I walked through to my desk and sat down, and rubbed my eyes. I felt tired.

"Well, it certainly looks as if Charlotte is still a virgin. So, I'm at a bit of a loss how to proceed. Of course, we need to discuss how you want to proceed? I know it's difficult, but Charlotte's age, and the fact that she is yet to gain her GCSEs, may want you both to carefully consider a termination?

Her mother stood up and walked to the window, peering out. She shook her head, once.
"No."
I glanced at Charlotte who sat with a strange calmness and dignity. She met my eyes and shook her head slightly once, also. I pursed my lips and nodded, understanding. Regardless of the situation, or how it had happened, this was a highly religious family for whom abortion was a great sin. I knew that to press them on the issue would simply cause greater discomfort for a family who would already have a huge amount to manage over the coming months. I gazed at them both, as Charlotte's mother came and sat back down.

"It's a miracle, isn't it Doctor?" she asked, her eyes shining with light as she smiled at me. I shrugged, completely uncertain how to respond. Beside me, Charlotte smiled to herself, a beatific expression on her lovely face.

"Perhaps I should do some research on the vaccine? I mean. just to discount any implications?" I suggested lamely. The mother swept away my words with a swift wave of her hand. I reached in to my filing cabinet and puled out a few leaflets about early pregnancy, passing them over in silence. Charlotte accepted them calmly, still serene.

"Well. So. I am not sure what else I can do to help you, just for now. Make an appointment for 12 weeks, and we can get you set up for further care and support. Is that OK?" I asked. Charlotte nodded and smiled, with no trace of fear.

"Doctor? I apologise for presenting such an unusual situation. I guess you haven't met anyone like me, before?" she asked, and her politeness and gentle voice made me feel once again, that this young lady was not the type to engage in unprotected sex. I'd spent enough time with young patients to be able to swiftly identify certain girls at risk, and Charlotte would never be considered one of those girls. I stared at her for a moment, and then puled he in to a quick hug. She hugged back, and I got a strange feeling that it were I who was being reassured.

Her mother stood and held out her hand, and I shook it limply. Together, the two made their way from the room, talking in excited whispers.

I walked over to the window and stared out sightlessly. As Charlotte and her mother passed the window, I re-focused and watched them for a moment. The girl walked with a serenity and grace rare in someone of her age. As she stood quietly by their car waiting to be let in, I watched. She lifted her face up to the sky, and despite the fact that the weather had persisted in maintaining a gloomy grey drizzle for most of the morning, I could have sworn that a small beam of light descended and lit up her delicate features. I rubbed my eyes, and turned from the window, angry with myself for what I must have just imagined.

Sitting at my desk once again, I turned to Charlotte's notes and made a new entry. I lifted my hands once, and then again, but could not force my muddled brain to come up with any sentient words to place against my patient's name. Before I could hesitate, I changed her file to allocate her to a colleague of mine, Dr. Marsh, a cynical, science-mad atheist with a strong contempt for religion. I knew that my moments of doubt, and the uncanny uncertainty I had felt when I examined my young charge could be of no help to her, now.

I pushed my computer off, and pulled on my coat. I need to lie down. I needed to consider whether my career was the right one for me. I needed a long crisp glass of white, and the oblivion of sleep.

I cancelled my afternoon appointments, and left the surgery. Walking to my car, the drizzle intensified, washed over my face and hair, and began to fall in earnest.